Etiology Of Anxiety, Mood And Distruptive Behavior Disor

焦虑、情绪和破坏性行为障碍的病因学

• 批准号: 6675608
• 负责人: Carolyn Zahn-Waxler
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6675608
• 关键词: adolescence (12-20); anxiety; anxiety disorders; child behavior disorders; clinical research; disease /disorder etiology; emotions; gender difference; health surveys; human subject; interview; longitudinal human study; mental disorders; questionnaires

This is a biobehavioral, longitudinal investigation of the role of emotion in the development of psychopathology in adolescence. The focus is on (a) the role of multiple components of negative emotions (anger, anxiety, sadness) in the evolution of psychopathology, and (b) socialization experiences and biological processes that contribute to emotion dysregulation and disorder. The dysregulated experience and expression of emotion is implicated in both externalizing (antisocial patterns) and internalizing (anxiety, depressed mood) disorders. Adolescence is a critical juncture in the development of these disorders. The incidence of psychopathology increases during this time period, and clinical problems become more differentiated along gender lines, i.e. more antisocial behavior in males and more anxiety and depression in females.Four groups of youths are studied: (1) comorbid externalizing and internalizing problems, (2) externalizing problems, (3) internalizing problems, and (4) asymptomatic. Youth range in age from 11 to 16 years and are studied at two time points, spaced two years apart. Equal numbers of males and females are studied in order to examine etiology of sex differences in symptoms, emotion regulation, and developmental changes in how disorders manifested. A multi-method, multi-respondent approach is used. Time 1 includes physiological and and neurohormonal functioning (ANS, HPA), behavioral observations of youth and family, experimental paradigms, structured psychatric interviews and questionnaires. Time 2 outcomes are based on interview and questionnaire methods. Data collection has just been completed for both time points so longitudinal analyses can now be conducted to determine predictors of psychiatric and psychological outcomes. At Time 1, neurohormonal patterns predict psychiatric symptoms differently for males and females: e.g. low testosterone levels are associated with anxiety/depression only in boys, while disruptive girls show a steep decline in production across the day. Analyses of DHEA (dehydroepiandrosterone) also identify important sex differences. Structural equation models estimated relationships between latent-anxiety-depression and disruptive behavior problem constructs and intra-individual differences in DHEA. DHEA levels were higher in females than males and were positively associated with age and pubertal development. DHEA levels decreased 29% from morning to mid-day and by 6% from mid-day to late afternoon. For girls, higher levels of anxiety-depression were associated with an increase in DHEA levels from mid-day to late-afernoon. DHEA reactivity tp social challenge was associated with anxiety-depression and disruptive behavior problems. The gender differences in DHEA levels differ from prevous findings of no differences for this sample in terms of their cortisol levels. This suggests that DHEA or the ratio of DHEA to cortisol may be more informative about potential sex differences in neurohormonal underpinnings of anxiety and mood disorders than will cortisol levels per se. In other Time 1 analyses, additional links between symptoms and differences in pubertal development, neuropsychological functioning, affective styles, coping and socialization have been identified. Longitudinal analyses now will examine biological and environmental factors that contribute to increases, decreases, shifts, and lack of change in psychiatric symptoms and psychological problems over time. When these longitudinal analyses are completed they will help to illuminate the interaction of biological factors and socialization experiences that influence the form of expression of psychopathology in adolescent males and females.

这是一项关于情绪在青春期精神病理学发展中的作用的生物行为纵向调查。重点是（a）消极情绪（愤怒、焦虑、悲伤）的多种成分在精神病理学演变中的作用，以及（B）导致情绪失调和紊乱的社会化经历和生物学过程。情绪的失调体验和表达与外化（反社会模式）和内化（焦虑，抑郁情绪）障碍有关。青春期是这些疾病发展的关键时刻。在这一时期，精神病理学的发病率增加，临床问题沿着性别线变得更加分化，即男性的反社会行为更多，女性的焦虑和抑郁更多。研究了四组青年：（1）共病的外部化和内部化问题，（2）外部化问题，（3）内部化问题，和（4）无症状。青年的年龄从11岁到16岁不等，在两个时间点进行研究，间隔两年。同样数量的男性和女性进行了研究，以检查症状，情绪调节，以及如何表现出障碍的发展变化的性别差异的病因。采用了多方法、多答复办法。时间1包括生理和神经激素功能（ANS，HPA），青年和家庭的行为观察，实验范式，结构化的心理访谈和问卷调查。时间2结果基于访谈和问卷调查方法。这两个时间点的数据收集刚刚完成，因此现在可以进行纵向分析，以确定精神和心理结局的预测因素。在时间1，神经激素模式预测男性和女性的精神症状不同：例如，低睾酮水平仅与男孩的焦虑/抑郁相关，而破坏性女孩在一天中表现出生产急剧下降。DHEA（脱氢表雄酮）的分析也确定了重要的性别差异。结构方程模型估计潜在的焦虑抑郁和破坏性行为问题的结构和DHEA的个体内差异之间的关系。女性DHEA水平高于男性，与年龄和青春期发育呈正相关。DHEA水平从早上到中午下降29%，从中午到下午晚些时候下降6%。对于女孩来说，从中午到下午晚些时候，更高水平的焦虑抑郁与DHEA水平的增加有关。DHEA对社会挑战的反应性与焦虑抑郁和破坏性行为问题有关。DHEA水平的性别差异与该样本在皮质醇水平方面没有差异的惊人发现不同。这表明DHEA或DHEA与皮质醇的比例可能比皮质醇水平本身更能提供有关焦虑和情绪障碍神经激素基础的潜在性别差异的信息。在其他时间1分析，症状和青春期发育，神经心理功能，情感风格，应对和社会化的差异之间的联系已被确定。纵向分析现在将检查生物和环境因素，这些因素导致精神症状和心理问题随着时间的推移而增加，减少，变化和缺乏变化。当这些纵向分析完成后，它们将有助于阐明影响青少年男性和女性精神病理学表达形式的生物因素和社会化经历的相互作用。